Depression is a common problem in society, which can have different manifestations depending on the type of depression suffered. Dr. Oliveros, an expert in Psychiatry, talks about the treatment of depression and its characteristics.
What is depression?
Depression is a mood disorder that affects about one third of the population. It is more frequent in women and involves a shutdown of the human being’s functions consisting, for example, in physical functions, it generates lack of energy, slowing down, fatigue, slowing down of movements, general shutdown.
It also generates shutdown of the cognitive area with lack of concentration, lack of attention, lack of calculation capacity, thinking is much slower, has less cognitive feeling and slowing problems. It also affects the affective area, with feelings of hopelessness, feelings of helplessness, helplessness, sadness, etc.
How does depression usually presents itself?
In neurotic depression the onset is insidious, usually appearing in childhood or adolescence. The development is intermingled with the development of the patient, the patient does not realize that he/she is depressed, he/she understands it as if it were a way of living, a way of understanding life. He does not realize it until he is 25 or 30 years old, when he sees that others are better off than he is, when he sees that others have aspirations, ambitions, while he feels incapable, he feels alone.
On the other hand, in major depression the onset is later, it usually begins between 35 and 40 years of age and usually appears in periods such as spring or autumn. It appears abruptly, generally not associated with stress factors or, if it is associated with stress factors, it is not proportional. If we make a simile of life with a movie, depression would be a shift of the film to black and white and in the later stages it would be a fade to black.
Are there common factors that cause depression?
There are no common factors in depression, there are specific characteristics of each depression. Thus, in major depression it usually appears in spring or summer, it is not associated with any stress factor.
In dysthymia, it appears from adolescence or childhood and, normally, worsening occurs when the patient suffers rejection, a situation of helplessness, loneliness, etc.
In the adaptive disorder, the trigger is always a stressful situation to which the patient reacts in a depressive way and then there are depressions secondary to drugs, to diseases in which the trigger is always a brain tumor, a brain disease of another type, or a pharmacological treatment with beta-blockers or other situations that produce depression.
How can depression be treated?
Classically the treatment of depression has relied on pharmacological treatment with antidepressants of the serotonin uptake inhibitor type, serotonin and noradrenaline uptake inhibitors, dopaminergic profile agents, etc. And on psychotherapy, which classically has been cognitive-behavioral and dynamic. In resistant cases, especially in the elderly, electroconvulsive therapy is and was used.
But in recent years new non-invasive, non-toxic techniques have been incorporated, which for the time being are used in resistant cases. They are gradually being introduced in the usual treatment of depression, such as neurofeedback, transcranial magnetic stimulation, deep brain stimulation with implantation of electrodes in the subcerebral cortex and, for the time being, ketamine. It is expected that there will be new drugs based on ketamine, which produce very rapid improvements in depression but, for the moment, the problem they have is tachyphylaxis, i.e., they lose their effect in a short time and are no longer useful for the patient.